The purpose of this conference proposal is related to all four of the AHRQ's core research activities: 1) developing health services research agendas and identifying strategies and mechanisms for studying them, 2) discussing and developing consensus around health services research methodological and technical issues, 3) disseminating health services information for formulating or evaluating health policy, managing health care programs and using or purchasing health services, and 4) developing partnerships with stakeholder organizations and building capacity to participate in research activities and using the results of health services research. The focus on measuring and improving health care quality through developing and testing a new model of delivering primary care with RNs as care and transition coordinators for individuals with multiple chronic conditions is directly linked to AHRQ's mission to improve quality, safety, efficiency, effectiveness of health care for all Americans. The Ambulatory Care Registered Nurse Performance Measurement Conference will bring together leadership and technical staff from current and past research that has/is focused on exploring measuring quality at the registered nurse provider level in ambulatory care and is distinct from advanced practice nurses (APNs) who also provide care in ambulatory settings. This 2-day invitational conference will be held in Philadelphia, PA on March 1-2, 2010 and include approximately 25 invited participants, as well as guest observers. The specific aims/objectives of the conference are to: 1. Convene a working research conference to formulate a research agenda and develop a strategy to study the testable components of the registered nurse (RN) role related to care coordination and transition in the patient-centered medical home (PCMH) related to improving patient outcomes, decreasing health care costs, and promoting sustainable system change. 2. Identify two nursing sensitive quality indicators that will measure the impact of RNs on cost, access, quality, and value in meeting goals of the PCMH. 3. Discuss methodological and technical issues related to measure development and testing. 4. Develop a research demonstration project proposal (R18) that tests the measures of RNs as care and transition coordinators, managing multiple chronic illnesses, in the PCMH (proposed submission date May 2010). 5. Disseminate conference findings to organizations and individuals that have the capability to use the information to improve the quality of health care services The conference's focus on measuring and improving health care quality through developing and testing a new model of delivering primary care with RNs as care and transition coordinators for individuals with multiple chronic conditions is directly linked to AHRQ's mission to improve quality, safety, efficiency, effectiveness of health care for all Americans. Transforming the quality of essential health care services and enhancing health care delivery in ambulatory settings is directly linked to improving the health of the nation.